OB

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Author:
charissa
ID:
133351
Filename:
OB
Updated:
2012-02-06 22:43:11
Tags:
Physiological Aspects Antepartum Care
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Ch 4
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  1. What are the benefits of having prenatal care within the first 12 weeks?
    id medical risks; basic lab work; patient education
  2. Naegele's Rule
    First day of LMP -3months, +7days
  3. Presumptive signs of pregnancy
    Those signs that only the mother can feel

    ex. amenorrhea, fatigue, nausea and vomiting, breast changes, quickening.
  4. Probable signs of pregnancy
    can be assessed by an experienced examiner

    ex. ballottement, positive pregnancy tests
  5. Positive signs of pregnancy
    Can only attribute to the presence of a fetus

    ex. sono, fetal hrt beat, fetal movement felt by someone other than the mother
  6. What are other ways to calc due date?
    Pregnancy wheels, fundal height (from pubic to top of fundus; 1 cm for each month pregnant), quickening felt at around 18 wks gestation
  7. Why are general body system changes required during pregnancy?
    to increase maternal cardiac output; to maintain uteroplacental perfusion and fetal demands.
  8. Layers of Uterus wall include:
    • Myometrium- outer Layer has longitudinal fibers that are mostly in the fundus adn assists in explelling the fetus during the birth process.
    • Middle layers- forms a figure 8; constricts blood vessels after childbirth to stop bleeding.
    • Inner layers- circular and located around the internal cervical os/opening; help keep the cervix closed during pregnancy
  9. Round ligament
    most troublesome during pregnancy; normally 10-12 cm long
  10. Fundal Height
    palpable at symphysis pubis between 12-14 weeks; rises to umbilicus at 22-24 weeks; teaches xyphoid process at term; drops between 38-40 weeks due to lightening.
  11. Placental profusion depends on
    maternal blood flow to the uterus
  12. How much of the total maternal blood volume is w/in the uterine vascular system at term of a normal pregnancy?
    1/6 of the maternal blood volume.
  13. What is the average rate of blood flow through the uterus?
    500 ml/min
  14. Three causes of decreased pacental perfusion:
    decreased maternal blood pressure

    uterine contractions

    maternal supine position
  15. Supine hypotention syndrome
    when the inferior vena cava is compressed by the mother being in supine position.
  16. Physiologic anemia of pregnancy
    more volume and less rbcs in it; NORMAL condition of pregnancy.
  17. Hypervolemic
    gain 1500mL of blood at term (1000 mL plasma/500 mL RBC)
  18. Hypercoagulation
    helps prevent bleed out after placenta detachment; can also increase chances of blood clots during pregnancy, and veracous veins.
  19. hemodynamic changes
    Increased: heart size, blood volume and cardiac output

    Decreased: systemic blood pressure, pulmonary vascular resistance
  20. Cardiac Output
    MOST dramatic and significant hemodynamic change during pregnancy B/C placenta profusion is TOTALLY dependent on maternal cardiac output
  21. Systemic Vascular Resistance (SVR)
    high flow, low resistance

    Progestin and prostaglandins relax wall of maternal blood vessels

    Diastolic more than systolic; lowest in 2nd trimester, but creeps back up in 3rd.

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